What should a nurse do first when noticing unequal breath sounds in a client with an oral endotracheal tube?

When a nurse notices unequal breath sounds in a client who has an oral endotracheal tube, the most immediate and appropriate action is to check the depth marking at the client's lips. This is crucial because unequal breath sounds may indicate that the endotracheal tube is improperly positioned, potentially causing one lung to be ventilated less than the other. Confirming that the tube is at the correct depth ensures that both lungs are receiving adequate airflow.

After verifying the position of the tube, if the placement is found to be correct, other options such as suctioning to clear any potential blockages or administering humidified oxygen may be considered based on the patient’s condition. However, without first ensuring that the tube is correctly positioned, any further interventions may not address the underlying issue effectively. Thus, checking the depth marking is a vital step in ensuring the safety and efficacy of airway management in this situation.